Rudeness is a disruptive behaviour which can impact a person’s working memory. Various studies have found that people who are exposed to rude behaviour, even as a witness, experience reduced problem-solving skills and creativity. The reason for this is that, on a basic level, rudeness is perceived as a threat and impairs cognitive skills because the brain is focused on the threat. Rude and disrespectful behaviour is prevalent in all industries and organisations, including healthcare.
The Impact of Rudeness on Medical Team Performance
The results of a randomised trial which was published in late 2015 in the official journal of the American Academy of Paediatrics, found that diagnostic and procedural performance scores were lower for members of teams exposed to rudeness than for member of the control team. The trial involved 72 NICU professionals recruited from four Israeli hospitals who were organised into 24 teams to participate in a one-hour training simulation involving an infant. Each team comprised of a physician and two nurses and were told they would be observed by an ICU expert via webcam. Teams were then randomly assigned to be exposed either to mildly rude statements unrelated to the teams’ performance, or neutral comments.
The teams exposed to rude comments had difficulty cooperating and communicating. Researchers found that rudeness explained just over half of the variance in diagnostic performance and 43 percent of procedural performance variance. Improper airway ventilation and medication errors observed in the trial were noted to have had the potential to seriously impact the health outcome of the patient.
The authors of the study state that it is possible performance could be further impaired if the source of rudeness is a medical colleague rather than a visitor, as in the trial; if the rudeness is specifically directed at the target; or if the intensity, length and frequency were expanded. Although it was already known that individuals exposed to rude behaviour perform poorly on cognitive tasks the study found that information sharing and help-seeking mediated the adverse effects of rudeness on medical teams.
A follow up study which involved some of 39 NICU teams being exposed to rude comments by the patient’s parent also found that rudeness had adverse consequences not only on diagnosis and intervention but also on team communication and workload sharing. That study concluded that interventions focused on teaching medical professional to avoid distraction may offer a way of mitigating adverse consequences of unavoidable disruptive behaviour.